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Thursday, January 26, 2017

As he wielded the scalpel, cardiac surgeon Jose Chacko Periappuram closed his eyes and said a prayer—let this patient not be among those unlucky souls whose heart hesitated to beat again. The prayer was intense this time, for Periappuram was going to perform the first heart re-transplant.

On March 6, 2014, Periappuram became the first cardiac surgeon to conduct the first successful heart re-transplant in the country.

Periappuram calls it a miracle. Gireesh, a 39-year-old software professional from Palakkad in Kochi was suffering from a rare heart ailment called dilated cardiomayopathy. His heart was not pumping blood efficiently. The first heart transplant was done on June 4, 2013, but soon he developed fever which led to an infection in one of his valves.

On February 27, 2014, he had a cardiac arrest after being resuscitated. On March 2, he was put on a ventilator as his condition worsened. On March 5, he suffered a second cardiac arrest. There were only two options—either remove the transplanted heart or the infected valve. Re-transplant is usually done when an already transplanted heart fails. But it accelerates risk as another surgery on a patient who had undergone cardiac surgery is not advisable. For every transplant, the heart should start beating again within four hours after being moved from the donor to the recipients’ body. The operation was a success.

“However hard we try, a 10 per cent mortality rate cannot be ruled out,” he says. “Hence, it is not always in the doctor’s hands to save a life.” Periappuram is the only cardiac surgeon in Kerala who has undertaken nine successful heart transplants so far. He was the first in Kerala to conduct a heart transplant in 2003.

Ask him what goes through his mind when he is about to operate on a patient, Periappuram says, “Absolutely nothing. I am detached and indifferent. Hardly any emotion clutters my mind. I am a doctor who has nothing else to think, but saves the patient in front of me.” He had a strange reply when asked why he chose to be a surgeon. “I was always fascinated by the beauty of a beating heart,” he says.

Call it a coincidence, but the doctor always had brave patients who made his task much easier, whether it be Gireesh or Abraham on whom he had conducted the first heart transplantation surgery. “Abraham was young. When I told him that I have never done a transplant before, he clasped my hands and said, ‘I believe in you and you can do it,” says the 55-year-old surgeon. It was more or less the same with Gireesh. He says the re-transplant surgery would not have been successful if Gireesh had not shown tremendous will and determination.

Periappuram, who is the chief cardiac surgeon and head of the department, cardio-thoracic department, Lisie Hospital, has many other ‘firsts’. He initiated a beating heart surgery programme in Kerala. He is also credited with the first successful TAR (Total Arterial Revascularization) and first awake bypass surgery in Kerala. Recognising his achievements, the government of India conferred on him the Padma Shri in 2011.

Periappuram now dreams of giving artificial hearts to those who cannot undergo transplants for various reasons. “Some might not get a suitable heart at the right time and for others, they cannot undergo heart transplants owing to the failure of other organs. Western countries are big on artificial hearts. Now my effort will be to make low price artificial hearts,” he says.

He also runs the Heart Care Foundation which provides heart surgeries to poor people by helping them financially.